Emergency room doctors speak out 

Not enough, say most

By Vivian Moreau

Although emergency room physicians in Whistler this week were learning the latest about myocardial infarction and fibrinolysis, in the halls outside Hilton Whistler’s meeting rooms the talk was about shortages of colleagues.

Emergency room physicians attending a University of Toronto-organized national conference in Whistler say it’s not just B.C. that’s having problems finding enough doctors to work in hospital emergency rooms.

Alan Lalonde is a family doctor in Alma, Quebec. In Whistler to attend a five-day conference with almost 200 other physicians from around the world who work in hospital emergency rooms, Dr. Lalonde said rural Quebec is having the same difficulties as B.C. in attracting doctors.

Although the province allows rural doctors to bill 15-20 per cent more than urban counterparts and offer sign up bonuses to new doctors, rural areas are still understaffed. And Lalonde said younger doctors especially shun the demanding emergency room.

“Younger doctors will get into ER initially and then tend to move on to other things,” he said.

As a family physician Lalonde puts in four shifts a month in his community’s emergency room, much less than Ashcroft, B.C. physician Raymond McConville, also attending the conference. McConville, who immigrated to Canada five years ago from the U.K. puts in two nights a week and one weekend a month in the community one hour from Kamloops. He works about 83 hours a week as do the town’s two other doctors. But many of Ashcroft’s residents travel to Kamloops and McConville said he and his colleagues would need another doctor if they were Ashcroft’s only medical option.

Doctors were in the news this week after emergency room physicians from Royal Columbian Hospital in New Westminster lambasted the provincial minister of health, saying overcrowding in the Lower Mainland hospital is so bad that they can no longer provide safe and timely care.

Also in Whistler for the conference was Dr. Joe Haegert, who works for Royal Columbian which sees about 55,000 patients a year and is short two emergency room positions. Haegert works about 16 10-hour shifts a month and sees about 30 people per shift. He says he can imagine the stresses placed on doctors like those in Sechelt who this week said they may no longer be able to keep the local hospital’s emergency room open 24 hours a day. Sechelt has lost seven of its 23 doctors in the past two years and the remaining 16 doctors, many of them nearing retirement, are burnt out from long hours running their practice and working four to eight shifts a month in the emergency room.

“It can be quite disruptive to one’s family practice if you’re doing emerg and family practice because you’ve got to have some days off and it’s stressful because emergency medicine can be a specialty unto itself,” Haegert said.

The solution would be to hire dedicated emergency room doctors but whether Sechelt can support the numbers a dedicated doctor requires is another question, Haegert said.

B.C. has about two million emergency room visits a year and although medical schools like UBC are increasing enrollment from 120 to 240 per year it takes time to get those students through school and into the system, Haegert said.

Whistler’s Health Care Centre faces some different challenges and some similarities to other rural B.C. communities. Although it usually has enough doctors who want to come practice in Whistler, says Dr. Rob Burgess, the number needed fluctuates dramatically between winter and summer.

“But the challenges are that we have to get our patients seen in Vancouver by specialists in a timely fashion,” said Dr. Burgess, “and of course there is some difficulty for everybody in the province in that regard.”

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